All Saints' Church, Lightwater - Consent Form - Children and Youth Activities Logo

  • Consent Form - Private and Confidential

    For use within regular Children and Youth activities of All Saints' Church, Lightwater. Valid to Sept 2025

  • Your data is being collected on behalf of the Parochial Church Council of All Saints Lightwater as Data Controller. The information below is necessary in order to register your child to participate in the activities provided throughout the year, and to provide details of health and additional contacts should an emergency arise. We will only share your data with the relevant parties, such as your doctor or emergency services as required. This data is updated annually so if you decide not to re-register, we will only keep the minimum of data required as per our Data Privacy Policy : https://docs-eu.livesiteadmin.com/3bd9df5b-d1b6-4930-87ea-b4d0b2e1f058/data-privacy-notice.pdf, or https://www.allsaintslightwater.org.uk/dataprivacy.htm

  • Child's Information

  • Date of Birth:   Pick a Date       

    Home Address:                   

    Contact Information

    Full name of parent / guardian:         
    Phone Number:      Email:      

    Alternative contact:         
    Relationship to child:  
    Phone Number:        

  • My child will be collected by         
    Relationship to child:         

  • Name of anyone NOT allowed to collect my child (if applicable):   
          

  • For children aged over 11 years

  • Medical Information:

  • If your child has any life-threatening medical conditions (e.g. asthma, epilepsy, diabetes) or any allergy (e.g. nuts, penicillin) please give details, including any medication that they take:
             

    Please give details of any medication that your child will be bringing with them to the group e.g. EpiPen, inhaler
                   

    Please give details of any additional needs that your child has (e.g. ADHD, SEN, visual/hearing impairment, dyspraxia, dyslexia, autism)
             

    If there is any other information you wish for us to know, that will help us to support your child, please state here.
             

    Family doctor’s name, surgery name, phone    
         
                          
          

  • Declaration and Consent

  • We are committed to treating your data with the utmost care and take appropriate steps to protect it. You have many rights regarding your personal data including seeing what we process and updating your information.

    For further information on how we process personal data please contact office@allsaintslightwater.org.uk

  • I agree to my child taking part in the above-mentioned activities. 

  • I accept that no activity is entirely risk free but that All Saints Lightwater will take every step to ensure my child’s safety. I acknowledge the need for responsible behaviour and obedience on his/her part.

    In the event of illness, having parental responsibility for the above name child, I give permission for medical treatment to be administered where considered necessary by a nominated first aider, or by suitable qualified medical practitioners.  If I cannot be contacted and my child should require emergency hospital treatment, I authorise a qualified medical practitioner to provide emergency treatment or medication.

    I also undertake to inform the Group Leader(s) as soon as possible if there are any changes to my child’s health, medication or needs and of any changes to our address or phone numbers given.

    I give permission for the information on this form to be stored in physical form and on a computer at All Saints and to be available to employees of the church as well as the leaders of children and youth teams.

    I authorise the data controller to share appropriate information with relevant parties in case of emergency.

  • Clear

  •       Pick a Date   
       

  • All Saints’ Lightwater PCC, Charity No. 1128176,

    Parish Office, Broadway Road, Lightwater, GU18 5SJ
  • Should be Empty: